Nutritional counseling improves quality of life and nutrient intake in hospitalized undernourished patients
Abstract
Objective Up to 60% of hospitalized patients are undernourished. We studied the impact of nutritional therapy on quality of life and food intake. Methods Undernourished patients were randomized into two groups. The nutritional therapy group (NT group) received individual nutritional counseling and interventions, including oral nutritional supplements if appropriate, by a dietitian. The oral nutritional supplement group (ONS group) received oral nutritional supplements in addition to hospital meals without further instruction or counseling. Study duration was 10 to 15 d. At baseline and before discharge (time point 1) we measured energy and protein intakes and quality of life. Quality of life was measured again 2 mo after discharge (time point 2). Results Energy and protein intakes increased between baseline and time point 1 in both groups (P=0.001). The NT group (n=18) met the energy requirements at time point 1 by 107% and of protein by 94%, the ONS group (n=18) by 90% and 88%, respectively. Hospital meals alone did not cover the requirements. From baseline to time point 1, quality of life increased in both groups. Quality of life increased further in the NT group from time point 1 to time point 2 (P=0.016), but not in the ONS group. Conclusion Both interventions caused a significant increase in energy and protein intakes and quality of life. In the NT group every patient received an efficacious individualized intervention. In contrast, the 7 of 18 patients in the ONS group…
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Five RCTs, all performed in the hospital setting, were identified providing evidence for comprehensive individualized nutritional interventions in older persons with malnutrition or at risk of malnutrition.
“Five RCTs (all performed in the hospital setting) were identified providing evidence for comprehensive individualized nutritional interventions in older persons with malnutrition or at risk of malnutrition (43)(44)(45)(46)(47).”
From ESPEN practical guideline: Clinical nutrition and hydration in geriatrics (2022) · cites this paper as [43]
All three RCTs showed benefits concerning quality of life in the group receiving individual nutritional care compared to usual care.
“Additionally, all three studies showed benefits concerning the quality of life in the group receiving individual nutritional J o u r n a l P r e -p r o o f care compared to the group with usual care (43)(44)(45).”
From ESPEN practical guideline: Clinical nutrition and hydration in geriatrics (2022) · cites this paper as [43]
Three RCTs of low to acceptable quality in older hospitalized patients at nutritional risk with various diagnoses or after acute stroke reported positive effects on energy and protein intake, body weight, complications, antibiotic use, readmissions, and functional measures.
“Three RCTs of low to acceptable quality investigated the effects of comprehensive individualized nutritional interventions in older hospitalized patients at nutritional risk with various diagnoses (43,44) or after acute stroke (45), and reported positive effects on energy and protein intake (43,44), BW (44,45), complications, antibiotic use, readmissions (44) and functional measures (44,45).”
From ESPEN practical guideline: Clinical nutrition and hydration in geriatrics (2022) · cites this paper as [43]
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ESPEN practical guideline: Clinical nutrition and hydration in geriatrics
Volkert, D., Beck, A. M., Cederholm, T., Cruz-Jentoft, A., Hooper, L., Kiesswetter, E., Maggio, M., Raynaud-Simon, A., Sieber, C., Sobotka, L., et al. (2022) · Clinical Nutrition · doi:10.1016/j.clnu.2022.01.024 · Cited by 516 · see citing works
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Loss of appetite in acutely ill medical inpatients: physiological response or therapeutic target?
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Neelemaat, F., van Keeken, S., Langius, J. A. E., de van der Schueren, M. A. E., Thijs, A., & Bosmans, J. E. (2017) · The Journal of nutrition, health and aging · doi:10.1007/s12603-017-0939-7 · Cited by 15 · see citing works
Lim, S. L., Lin, X., Chan, Y. H., Ferguson, M., & Daniels, L. (2013) · Annals of the Academy of Medicine, Singapore · doi:10.47102/annals-acadmedsg.v42n10p507 · Cited by 14 · see citing works
- Authors
- Rüfenacht, U., Rühlin, M., Wegmann, M., Imoberdorf, R., & Ballmer, P. E.
- Affiliations
- Kantonsspital Winterthur (CH)
- Corresponding author
- Ballmer, Peter E.
- ORCID
- Imoberdorf, Reinhard
- Venue
- Nutrition
- Publisher
- Elsevier BV
- Published
- 2010-01
- Volume
- 26
- Issue
- 1
- Pages
- 53-60
- ISSN
- 0899-9007 (ISSN-L)
- OpenAlex
- W2148704018
- Cited by
- 103
- References
- 1
- Citations by year
- 2026: 9 · 2025: 2 · 2024: 2 · 2023: 4 · 2022: 4 · 2021: 8 · 2020: 5 · 2019: 6 · 2018: 3 · 2017: 5 · 2016: 7 · 2015: 8 · 2014: 8 · 2013: 15 · 2012: 7
- FWCI
- 5.47
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Nutrition (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Health Sciences › Health Professions › Health Information Management › Dietetics, Nutrition, and Education
- Keywords
- nutrition counseling, quality of life, oral nutritional supplements, energy intake, protein intake, dietitian intervention, hospital food, malnutrition
- MeSH terms
- Aged, Aged, 80 and over, Energy Intake, Counseling, Diet, Dietary Proteins, Female, Food Service, Hospital, Hospitalization, Humans, Male, Middle Aged, Nutritional Requirements, Nutritional Status, Patient Education as Topic, Quality of Life, Dietary Supplements, Malnutrition
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